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PRINCE GEORGES COUNTY PUBLIC SCHOOLS OFFICE OF HEALTH SERVICES AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION STUDENT NAME DATE of BIRTH Individual Submitting the Authorization (Parent/Guardian
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Parent/guardian of student person refers to the individual(s) who are legally responsible for the student's well-being and education.
The parent/guardian of the student is required to file the information related to the parent/guardian of student person.
To fill out the parent/guardian of student person information, one needs to provide details such as name, contact information, relationship to the student, and any other relevant information.
The purpose of the parent/guardian of student person form is to ensure that the educational institution has accurate and up-to-date information about the individual(s) responsible for the student.
The information that must be reported on the parent/guardian of student person includes name, address, contact details, relationship to the student, and any emergency contact information.
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